The concept of limb transplant goes back to 5th century AD, as depicted by a medieval painting

While recent scientific and medical breakthroughs have made the scope of limb-based prosthetic and bionics more feasible, the very notion of a limb transplant as a concept harks back to 5th century AD. At least that is the date that a group of Italian researchers has identified from a 14th century painting created by lesser-known artist, Matteo di Pacino. Currently being housed at the North Carolina Art Museum in Raleigh, the artwork depicts doctors ‘curing’ a man’s diseased leg by replacing it with another human leg. Now from the historical perspective, this almost 650-year old painting visually recreates a legend from 5th century AD that entails a miracle achieved by the Saints Cosmas and Damian in 474 AD.

According to the legend, Saints Cosmas and Damian were originally two physicians who converted to Christianity and made their subsequent practices in the then-Roman province of Syria. In one of their medical cases, they performed a ‘miracle’ by severing the diseased leg of a patient and then replacing it with the healthy leg of a deceased Ethiopian man. After the limb transplant, the amputated leg was possibly hidden inside the coffin of the Ethiopian male.

Now beyond the story and its embellishments, the researchers from Institute of Evolutionary Medicine (IEM) – at the University of Zurich, analysed the aforementioned medieval painting in detail. And according to them –

Morphologically, the amputated limb appears to be edematous, soft and putrid, with some skin lesions consistent with wound drainages. Based on these characteristics, we speculate the man had suffered from an infected gangrene of the right leg.

Credit: North Carolina Art Museum

So if we leave out the ‘miraculous’ scope, the incident in itself pertains to a scenario where trained physicians actually considered the process of limb transplant as a solution for infected gangrene. Simply put, such a notion possibly existed in then-contemporary medical ambit, before being integrated into a religious legend.

According to paleopathographist Raffaella Bianucci, these doctors might have even tried to actually go through with the procedure. But of course, from the medical viewpoint, the requirement of compatibility between the donor and the recipient would have made such processes invalid – thus resulting in failures. On the other hand, back in January, archaeologists excavated an actual 2,200-year old prosthetic leg specimen that was specially furnished for its user with a deformed knee. Found in China, the discovery suggested that the ancients made use of prosthetic props for solving many a medical deformity – though transplanting surgeries would have been rare.

The study was originally published in the Journal of Vascular Surgery.